痛泻要方加味方治疗腹泻型肠易激综合征（肝郁脾虚证）的临床观察

发布时间：2018-04-22 04:40

本文选题：腹泻型肠易激综合征 + 肝郁脾虚证　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:通过运用痛泻要方加味方治疗腹泻型肠易激综合征(肝郁脾虚证)患者,并与西药匹维溴铵进行对照,观察其对IBS-D患者临床症状的改善情况,以客观评价痛泻要方加味方的疗效,以便推广其应用。方法:选择60例符合纳入标准的IBS-D患者,将其随机分为2组,治疗组30例和对照组30例,以28天为一疗程,治疗1个疗程,治疗组采用加味方治疗,对照组采用匹维溴铵50mg tid治疗;通过问卷调查方式,记录疗程开始前及结束后受试者临床症状积分,停药1月后进行随访,并观察不良反应,比较两组症状总积分、各项症状积分以及远期疗效,客观评估痛泻要方加味方治疗IBS-D的临床效果。结果:1.综合疗效方面:治疗4周后,治疗组总有效率为93.33%,对照组为.66.67%,二者相比有统计学意义,说明在综合疗效方面治疗组明显优于对照组;2.改善症状方面:主症方面,治疗组和对照组均能显著改善大便次数、大便性状、腹痛或者腹部不适、胸胁胀满窜痛,且在改善这些症状方面均有较好的远期疗效,除了在改善大便次数的远期疗效上两组疗效相当,其余相比治疗组疗效均明显优于对照组;在次症方面,两组在改善肠鸣矢气及腹胀上均有较好疗效,对照组在改善便下粘液及情志抑郁或烦躁上疗效不明显,除了腹胀治疗4周后以及肠鸣矢气治疗后的随访显示两组疗效相当,在其他次要症状上治疗组疗效均明显优于对照组;3.远期疗效方面:停药1月后,治疗组总有效率86.67%,对照组为53.33%,二者相比有统计学意义,说明在远期疗效方面治疗组明显优于对照组。由此可以得出结论,痛泻要方加味方对改善IBS-D患者临床症状疗效显著,并且具有良好的远期疗效。
[Abstract]:Objective: to observe the improvement of clinical symptoms of IBS-D patients by using Tongxieyoufang Jiawei recipe to treat diarrhea irritable bowel syndrome (liver-stagnation and spleen deficiency syndrome), and to compare it with piveronium bromide, a western medicine. Objective to evaluate the curative effect of Tongxie Youfang Jiawei prescription in order to popularize its application. Methods: sixty patients with IBS-D were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). The control group was treated with 50mg tid, the clinical symptom scores before and after the course of treatment were recorded by questionnaire, and the adverse reactions were observed and compared between the two groups. Objective to evaluate the clinical effect of Tongxie decoction Jiawei prescription in treating IBS-D. The result is 1: 1. Comprehensive curative effect: after 4 weeks of treatment, the total effective rate of the treatment group was 93.3333 and that of the control group was .66.67. there was statistical significance between the two groups, which indicated that the treatment group was obviously superior to the control group in the comprehensive curative effect. Improvement of symptoms: both the treatment group and the control group could significantly improve the number of defecation, defecation traits, abdominal pain or abdominal discomfort, chest and flank full of pain, and had good long-term effect in improving these symptoms, the treatment group and the control group were able to improve the number of defecation times, defecation traits, abdominal pain or abdominal discomfort. In addition to the long-term effect of improving the number of defecation, the two groups had the same curative effect, and the other two groups were obviously superior to the control group in the treatment group. In terms of secondary symptoms, both groups had better results in improving the bowel sagittal qi and abdominal distension. In the control group, there was no obvious effect on the improvement of mucus and mood depression or irritability, except for 4 weeks after abdominal distension treatment and after the treatment of bowel sagittal qi treatment, the two groups had the same curative effect, and the treatment group was obviously superior to the control group in other secondary symptoms. Long-term curative effect: after one month, the total effective rate of the treatment group was 86.67 and that of the control group was 53.33, which showed that the treatment group was obviously superior to the control group in the long-term curative effect. It can be concluded that Tongxieyoufang Jiawei prescription is effective in improving the clinical symptoms of IBS-D patients and has good long-term effect.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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